Visual Acuity Testing in Children-

Snellen letter chart: Consists of lines of letters of decreasing size.
  • Children should stand 10 feet from wall
  • Nurse tests right eye first, covers the child’s left eye.
  • For children unable to read letters, the Tumbling E or HOTV test can be used.
    • HOTV test – consists of a wall chart composed of letters H, O, T, V.
    • Examiner points to a letter on the wall chart, and the child points to the corresponding letter on his own smaller chart held in his/her hand.
  • Allen card test – Uses familiar figures/pictures that the child knows

Visual Acuity Testing in infants or difficult-to-test children

In newborns, vision is tested by checking for light perception.
  • A light is shone into baby’s eyes and RN checks for responses such as blinking, papillary constriction, blinking, closing the eyes, increased alertness, or following the light.
  • RN can also test for visual acuity by having the infant fix on a target and follow the target. (Human face is excellent for this)
  • Hold the infant upright and move face slowly from side to side. Infant should follow your facial movement.
  • Visual loss or other serious eye problems – fixed pupils, strabismus, constant nystagmus, the sun-setting sign, and slow lateral movements.

Peripheral Vision – Have child fixate on a specific object directly in front of them. Hold finger or a pencil in the child’s peripheral vision. Have child tell RN when he or she sees that item (while still looking ahead.)

Color Vision – Affects 8% to 10% of Caucasian males.
· Ishihara test and Hardy-Rand-Rittler test – cards printed in color. Another image is printed inside the outside shape. (confusion color)
· Unaffected individuals can see both images